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Heparin Anticoagulation

  • Chapter
Book cover Management of Acute Pulmonary Embolism

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

In the initial treatment of patients presenting with acute pulmonary embolism (PE), anticoagulation is based either on unfractionated heparin (UFH) by continuous intravenous infusion and activated partial thromboplastin time monitoring, or on low-molecular-weight heparin (LMWH) given by once- or twice-daily subcutaneous injections. There have been several studies comparing the use of UFH and LMWH for the treatment of deep vein thrombosis (DVT), all demonstrating that LMWH is at least as effective and safe as UFH by continuous intravenous infusion. Fewer studies have compared the use of UFH and LMWH for the treatment of acute PE, but the evidence is that, as in DVT, LMWH is equally effective and safe compared to UFH. Furthermore, LMWH offers the convenience of out-of-hospital treatment for hemodynamically stable patients with nonmassive PE without the need for laboratory monitoring. Therefore, in the recent guidelines of the American College of Chest Physicians, either LMWH or UFH is recommended for the initial treatment of venous thromboembolism. In patients with advanced renal insufficiency, the recommendation is to use UFH rather the LMWH.

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Authors and Affiliations

  1. Thrombosis Research Unit, Foothills Hospital, University of Calgary, Calgary, Alberta, Canada

    Graham F. Pineo MD, FRCPC, FACP & Russell D. Hull MBBS, MSc, FRCPC, FACP

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  1. Graham F. Pineo MD, FRCPC, FACP
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  2. Russell D. Hull MBBS, MSc, FRCPC, FACP
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Editors and Affiliations

  1. Department of Cardiology and Pulmonology, Georg August University, Goettingen, Germany

    Stavros V. Konstantinides MD (Professor of Medicine) (Professor of Medicine)

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© 2007 Humana Press Inc., Totowa, NJ

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Pineo, G.F., Hull, R.D. (2007). Heparin Anticoagulation. In: Konstantinides, S.V. (eds) Management of Acute Pulmonary Embolism. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-287-8_9

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  • DOI: https://doi.org/10.1007/978-1-59745-287-8_9

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-644-3

  • Online ISBN: 978-1-59745-287-8

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